Individual provider Active NPI

Jenna Rae Gibson, FNP

  • Nurse Practitioner
  • Mandeville, LA
National Provider Identifier
1609554146
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
230156 Issued in LA
Practice address
1510 W Causeway Approach Ste B
Mandeville, LA 70471-3022
Phone
(985) 892-3360
Fax
(985) 892-3375
NPI assigned
Jul 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 230156 LA Primary

Addresses

Primary practice location

1510 W Causeway Approach Ste B
Mandeville, LA 70471-3022

Mailing address

1510 W Causeway Approach Ste B
Mandeville, LA 70471-3022
Phone (985) 892-3360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222001756 LA Practitioner - Nurse Practitioner 8729422308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3000 34TH St
Metairie, LA 70001-2016

39101 Oak St
Pearl River, LA 70452-5031

PO Box
Suite 6706
Metairie, LA 70009-6706

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
230156LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Tammany Cardiovascular Specialists LLC CurrentSince Mar 1, 2024 Accepting new patients
Neuro Care of Louisiana, LLC CurrentSince Jan 28, 2025 Accepting new patients
Covington Express Medical Services, LLC PastSince Nov 7, 2025 Accepting new patients
Total Family Medical, LLC Past Accepting new patients

Locations

648 Crestwood Blvd
Covington, LA 70433
Phone (904) 962-6005

15739 Professional Plz
Hammond, LA 70403
Phone (985) 288-5088

5620 Read Blvd
#6
New Orleans, LA 70127

5620 Read Blvd
Ste 600
New Orleans, LA 70127
Phone (504) 592-6437

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23442/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/HBABBD
  • Direct secure messaging: jenna.gibson.1@10157.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1609554146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 W CAUSEWAY APPROACH STE B",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713022",
            "telephone_number": "985-892-3360",
            "fax_number": "985-892-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 W CAUSEWAY APPROACH STE B",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713022",
            "telephone_number": "985-892-3360",
            "fax_number": "985-892-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JENNA",
        "middle_name": "RAE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "230156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.